Helping Someone with Borderline Personality Disorder

How to Recognize BPD in a Loved One and Improve Your Relationship

Does someone close to you suffer from borderline personality disorder (BPD)? If so, you already know that BPD not only affects those with the diagnosis—it affects everyone who cares about them. People with BPD have difficulty regulating their emotions and behavior and that can take a heavy toll on their partners, family members, and friends. But there’s hope, both for the person with BPD and for you. You can’t force someone to get treatment for BPD, but you can take steps to improve communication, set healthy boundaries, and stabilize the relationship.

What you need to know about BPD

People with borderline personality disorder (BPD) tend to have major difficulties with relationships, especially with those closest to them. The wild mood swings, angry outbursts, chronic abandonment fears, and impulsive and irrational behaviors can leave loved ones feeling helpless, abused, and off balance. Partners and family members of people with BPD often say it’s like being on an emotional roller coaster with no end in sight. You may feel like you’re at the mercy of your loved one’s BPD symptoms—trapped unless you leave the relationship or the person takes steps to get better. But you have more power than you think.

You can change the relationship by managing your own reactions, establishing firm limits, and improving communication between the two of you. There’s no magic cure but with the right treatment and support, many people with BPD can and do get better and their relationships can become more stable and rewarding. In fact, patients with the most support and stability at home tend to get better sooner than those whose relationships are more chaotic and insecure. Whether it’s your partner, parent, child, sibling, friend, or other loved one, you can improve both the relationship and your own quality of life, even if the person with BPD isn’t ready to acknowledge the problem or seek treatment.

Learning all you can

If your loved one has borderline personality disorder, it’s important to recognize that he or she is suffering. The destructive and hurtful behaviors are a reaction to deep emotional pain. In other words, they’re not about you. When your loved one does or says something hurtful towards you, understand that the behavior is motivated by the desire to stop the pain he or she is experiencing; it’s rarely deliberate.

Learning about BPD won’t automatically solve your relationship problems, but it will help you understand what you’re dealing with and handle difficulties in more constructive ways.

Recognizing the signs and symptoms of BPD

Recognizing the signs and symptoms of borderline personality disorder is not always easy. BPD is rarely diagnosed on its own, but often in conjunction with co-occurring disorders such as depression, bipolar disorder, anxiety, an eating disorder, or substance abuse. Your family member or loved one with BPD may be extremely sensitive, so small things can often trigger intense reactions. Once upset, borderline people are often unable to think straight or calm themselves in healthy ways. They may say hurtful things or act out in dangerous or inappropriate ways. This emotional volatility can cause turmoil in their relationships and stress for family members, partners, and friends.

Many people in a close relationship to someone who suffers from BPD often know that something is very wrong with the behavior of their loved one, but have no idea what it is or if there is even a name for it. Learning a diagnosis can often come as a source of both relief and hope.

Does your loved one have borderline personality disorder?

In your relationship:

Do you feel like you have to tiptoe around your loved one, watching every little thing you say or do for fear of setting them off? Do you often hide what you think or feel in order to avoid fights and hurt feelings?

Does your loved one shift almost instantaneously between emotional extremes (e.g. calm one moment, raging the next, then suddenly despondent?) Are these rapid mood swings unpredictable and seemingly irrational?

Does your loved one tend to view you as all good or bad, with no middle ground? For example, either you're "perfect" and the only one they can count on or you're "selfish" and "unfeeling" and never truly loved them.

Do you feel like you can't win, that anything you say or do will be twisted and used against you? Does it feel as if your loved one's expectations are constantly changing, so you're never sure how to keep the peace?

Is everything always your fault? Do you feel constantly criticized and blamed for things that don't even make sense? Does the person accuse you of doing and saying things you never did? Do you feel misunderstood whenever you try to explain or reassure your partner?

Do you feel manipulated by fear, guilt, or outrageous behavior? Does your loved one make threats, fly into violent rages, make overly dramatic declarations, or do dangerous things when they think you're unhappy or may leave?

If you answer "yes" to most of these questions, your partner or family member might have borderline personality disorder.

To help someone with BPD, first take care of yourself

When a family member or partner has borderline personality disorder, it’s all too easy to get caught up in heroic efforts to please and appease him or her. You may find yourself putting most of your energy into the person with BPD at the expense of your own emotional needs. But this is a recipe for resentment, depression, burnout, and even physical illness. You can’t help someone else or enjoy sustainable, satisfying relationships when you’re run down and overwhelmed by stress. As in the event of an in-flight emergency, you must “put on your own oxygen mask first.”

Avoid the temptation to isolate. Make it a priority to stay in touch with family and friends who make you feel good. You need the support of people who will listen to you, make you feel cared for, and offer reality checks when needed.

You’re allowed (and encouraged) to have a life! Give yourself permission to have a life outside of your relationship with the person with BPD. It’s not selfish to carve out time for yourself to relax and have fun. In fact, when you return to your BPD relationship, you’ll both benefit from your improved perspective.

Join a support group for BPD family members. Meeting with others who understand what you’re going through can go a long way. If you can’t find an in-person support group in your area, you may want to consider joining an online BPD community.

Don’t neglect your physical health. Eating right, exercising, and getting quality sleep can easily fall by the wayside when you’re caught up in relationship drama. Try to avoid this pitfall. When you’re healthy and well rested, you’re better able to handle stress and control your own emotions and behaviors.

Learn to manage stress. Getting anxious or upset in response to problem behavior will only increase your loved one’s anger or agitation. By practicing with sensory input, you can learn to relieve stress as it’s happening and stay calm and relaxed when the pressure builds.

Remember the 3 C's rule

Many friends or family members often feel guilty and blame themselves for the destructive behavior of the borderline person. You may question what you did to make the person so angry, think you did something to deserve the abuse, or feel responsible for any failure or relapse in treatment. But it’s important to remember that you’re not responsible for another person. The person with BPD is responsible for his or her own actions and behaviors.

The 3 C's are:

I didn't cause it.

I can't cure it.

I can't control it.

Source: Out of the Fog

Communicating with someone who has BPD

Communication is a key part of any relationship but communicating with a borderline person can be especially challenging. People in a close relationship with a borderline adult often liken talking with their loved one to arguing with a small child. People with BPD have trouble reading body language or understanding the nonverbal content of a conversation. They may say things that are cruel, unfair, or irrational. Their fear of abandonment can cause them to overreact to any perceived slight, no matter how small, and their aggression can result in impulsive fits of rage, verbal abuse, or even violence.

The problem for people with BPD is that the disorder distorts both the messages they hear and those they try to express. BPD expert and author, Randi Kreger, likens it to “having ‘aural dyslexia,’ in which they hear words and sentences backwards, inside out, sideways, and devoid of context.”

Listening to your loved one and acknowledging his or her feelings is one of the best ways to help someone with BPD calm down. When you appreciate how a borderline person hears you and adjust how you communicate with them, you can help diffuse the attacks and rages and build a stronger, closer relationship.

Communication tips

It’s important to recognize when it’s safe to start a conversation. If your loved one is raging, verbally abusive, or making physical threats, now is not the time to talk. Better to calmly postpone the conversation by saying something like, “Let’s talk later when we’re both calm. I want to give you my full attention but that’s too hard for me to do right now.”

When things are calmer:

Listen actively and be sympathetic. Don’t let yourself be distracted by the TV, computer, or cell phone. Avoid interrupting or trying to redirect the conversation to your concerns. Set aside your judgment, withhold blame and criticism, and show your interest in what’s being said by nodding occasionally or making small verbal comments like “yes” or “uh huh.” You don’t have to agree with what’s being said to make it clear that you’re listening and sympathetic.

Focus on the emotions, not the words. The feelings of the person with BPD communicate much more than what the words he or she is using. People with BPD need validation and acknowledgement of the pain they’re struggling with. Listen to the emotion your loved one is trying to communicate without getting bogged down in attempting to reconcile the words being used.

Do what you can to make the person with BPD feel heard. Don’t try to make them wrong, win the argument, or invalidate their feelings, even when what they’re saying is totally irrational.

Try to stay calm, even when the person with BPD is acting out. Avoid getting defensive in the face of accusations and criticisms, no matter how unfair they may be. Defending yourself will only make your loved one angrier. Walk away if you need to give yourself time and space to cool down.

Seek to distract your loved one when emotions rise. Anything that draws your loved one’s attention can work, but distraction is most effective when the activity is also soothing. Try exercising, sipping hot tea, listening to music, grooming a pet, painting, gardening, or completing household chores.

Talk about things other than the disorder. You and your loved one’s lives aren’t solely defined by the disorder, so make the time to explore and discuss other interests. Discussions about light subjects can help to diffuse the conflict between you and may encourage your loved one to discover new interests or resume old hobbies.

Don’t ignore self-destructive behaviors and suicidal threats

If you believe your loved one is at an immediate risk for suicide Do NOT leave the person alone. Call your loved one’s therapist or:

In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK.

In other countries, call your country’s emergency services number or visit IASP to find a suicide prevention helpline.

Setting healthy boundaries with a borderline loved one

One of the most effective ways to help a loved one with BPD gain control over his or her behavior is to set and enforce healthy limits or boundaries. Setting limits can help your loved one better deal with the outside world, where schools, work, and the legal system, for example, all set and enforce strict limits on what is and what is not acceptable behavior. Establishing boundaries in your relationship can replace the chaos and instability of your current situation with an important sense of structure and provide you with more choices about how to react when confronted by negative behavior. When both parties honor the boundaries, you’ll be able to build a sense of trust and respect between you, which are key ingredients for any meaningful relationship.

Setting boundaries is not a magic fix for a relationship, though. In fact, things may initially get worse before they get better. The person with BPD fears rejection and is sensitive to any perceived slight. This means that if you’ve never set boundaries in your relationship before, your loved one is likely to react badly when you start. If you back down in the face of your loved one’s rage or abuse, you’ll only be reinforcing his or her negative behavior and the cycle will continue. But remaining firm and standing by your decisions can be empowering to you, beneficial to your loved one, and ultimately transform your relationship.

How to set and reinforce healthy boundaries

Talk to your loved one about boundaries at a time when you’re both calm, not in the heat of an argument. Decide what behavior you will and will not tolerate from your loved one and make those expectations clear. For example, you may tell your loved one, “If you can’t talk to me without screaming abuse at me, I will walk out.”

Do...

Calmly reassure the person with BPD when setting limits, by saying something like, "I love you and I want our relationship to work but I can't handle the stress caused by your behavior. I need you to make this change for me."

Make sure everyone in the family is in agreement on the boundaries—and how to enforce the consequences if they're ignored.

Think of setting boundaries as a process rather than a single event. Instead of hitting your loved one with a long list of boundaries all at once, introduce them gradually, one or two at a time.

Don't...

Make threats and ultimatums that you can't follow through on. As is human nature, your loved one will inevitably test the limits you set. If you relent and don't enforce the consequences, your loved one will know the boundary is meaningless and the negative behavior will continue. Ultimatums are a last resort (and again, you must be prepared to follow through).

Tolerate abusive behavior. No one should have to put up with verbal abuse or physical violence. Just because your loved one's behavior is the result of a personality disorder, it doesn't make the behavior any less real or any less damaging to you or other family members.

Enable by protecting the person with BPD from the consequences of his or her actions. If you've tried and failed and your loved one won't respect your boundaries and continues to make you feel unsafe, then you may need to leave. It doesn't mean you don't love the person with BPD, but your self-care should always take priority.

Supporting your loved one's BPD treatment

Borderline personality disorder is highly treatable, yet it’s common for people with BPD to avoid treatment or deny that they have a problem. Even if this is the case with your loved one, you can still offer support, improve communication, and set boundaries while continuing to encourage your friend or family member to seek professional treatment.

While medication options are limited, the guidance of a qualified therapist can make a huge difference to your loved one’s recovery. BPD therapies, such as Dialectical Behavior Therapy (DBT) and schema-focused therapy, can help your loved one work through his or her relationship and trust issues and explore new coping techniques, learning how to calm the emotional storm and self-soothe in healthy ways.

How to support treatment

If your loved one won’t acknowledge that he or she has a problem with BPD, you may still want to consider couple’s therapy, where the focus is on the relationship and promoting better communication between you, rather than on your loved one’s disorder. This may be easier for your loved one to agree to and may eventually encourage him or her to pursue BDP therapy.

Encourage your loved one to explore healthy ways of handling stress and emotions by using sensory-based stimulation, practicing mindfulness, and employing relaxation techniques such as yoga, deep breathing, or meditation. Again, you can participate with your loved one in any of these therapies, which can strengthen the bond between you and may encourage your friend or family member to pursue other avenues of treatment as well.

By developing an ability to tolerate distress, your loved one can learn how to press pause when the urge to act out or behave impulsively strikes. HelpGuide’s free Emotional Intelligence Toolkit offers a step-by-step, self-guided program to teach your loved one how to ride the “wild horse” of overwhelming feelings while staying calm and focused.

Setting goals for BPD recovery: Go slowly

When supporting your loved one’s recovery, it’s important to be patient and set realistic goals. Change can and does happen but, as with making any changes to the brain, it takes time.

Take baby steps rather than aiming for huge, unattainable goals that only set you and your loved one up for failure and discouragement. By lowering expectations and setting small goals to be achieved step by step, you and your loved one with BPD have a greater chance of success.

Supporting a loved one’s recovery can be both extremely challenging and rewarding. You need to take care of yourself but the process can help you grow as an individual and strengthen the relationship between you.

Resources and references

Help for Families – Videos, book recommendations, and links to support programs for family members of people with BPD. (Borderline Personality Disorder Resource Center)

Family Guidelines – Guidelines on helping a loved one with BPD including setting limits and managing crises. (National Education Alliance for Borderline Personality Disorder)